Automation of Flow Cytometric Analysis for Quality-Assured Follow-up Assessment to Guide Curative Therapy for Acute Lymphoblastic Leukaemia in Children (AUTOFLOW)

Project Coordinator: Technische Universität Wien, AUT

Project Partners:
Prof. Dr. Michael Dworzak , Children´s Cancer Research Institute/Immunological Diagnostics
Charité – Universitätsmedizin Berlin, DEU
CogVis Software and Consulting GmbH, AUT
Informations- und Kommunikationsgesellschaft mbH, DEU

Project summary, results and future outlook:
Acute Lymphoblastic Leukaemia is the most frequent leukaemia entity in children and adolescents. Despite continued progress and refinement of therapeutic approaches, disease relapse due to insufficient extinction of leukaemic blasts still remains the number one cause of treatment failure. About 15-20% of paediatric patients with the disease still suffer from relapse. Flow cytometry (FCM) is one of the methodologies most useful in this respect, because it is widely available and applicable to most patients. While sample preparation, antibody panels, staining procedures, and FCM acquisition can be harmonized straightforwardly, data analysis and interpretation rely largely on operator skills and experience. These assessments are time-consuming and costly to be attained via staff-training, online support between twinning laboratories, and continued quality control. Hence, these requirements represent the current bottleneck of safely applying the FCM Minimal Residual Disease (MRD) methodology in a growing community of diagnostic laboratories to the benefit of an increasing number of patients with leukaemia.
To address this bottleneck, AutoFLOW aims at developing an objective and automated tool for multi-parameter FCM data analysis with robust and reliable MRD quantification. The consortium engages professionals from the medical and ICT fields in a network where the exchange of knowledge culminates in a valid solution for automated FCM analysis for clinical follow-up assessment of Acute Lymphoblastic Leukaemia (ALL).
Showing the success of this project, the software “FLOWVIEW” was already developed and is available for testing on the AUTOFLOW website (link below). FLOWVIEW is based on the powerful algorithms and database of expert-evaluated FCM records. Users can upload FCM files, perform a fully automated gating procedure (duration so far <90sec.) to describe populations of healthy and blast cells, currently with a precision of >90% so far, but with a growing number of special ALL variants this figure will improve. FlowVIEW can visualise 20 (actually up to 120) different plots of a cell sample with up to 2 million data points in real time, i.e. the user is able to zoom in in each plot and consider each cell population in detail. This is possible because the processes are calculated directly on the graphics card and therefore very large amounts of data such as the FCM output can be processed quickly.
To improve and standardize quality-assured MRD-assessment necessary for proper treatment selection upon assessment of leukaemic response parameters, the AUTOFLOW team allows dissemination of automated FCM-MRD analysis to medical centres which have no established expertise – for the benefit of diseased children with ALL.

Funded under the Seventh Framework Programme (FP7-PEOPLE-2013-IAPP) by the European Commission
Duration: 01.01.2014 – 31.12.2017